Cachexia – ABC CARDIOL

IJCS

Editorial

Hospital Malnutrition, Inflammation, and Cardiovascular Diseases

Camila Weschenfelder et al. Aline Marcadenti

Malnutrition in hospitalized patients, whose prevalence ranges between 40% and 60% in Latin America, is related to longer hospital stays, worse clinical outcomes, and increased hospitalization costs. The consequences related to hospital malnutrition have also been reported among patients diagnosed with cardiovascular disease (CVD). In these individuals, an exacerbated inflammatory state is associated with malnutrition, loss of muscle mass, and cardiac cachexia, especially in the more advanced stages of the disease.

Globally, there is a policy that aims to recognize the importance of hospital malnutrition and its consequences. In Brazil, in 2018, the campaign “Say no to malnutrition” was published, composed of 11 steps to combat hospital malnutrition. In this campaign, the first step involves risk stratification and nutritional assessment for subsequent implementation and monitoring of appropriate nutritional therapy.

[…]

Ler artigo completo

IJCS

Original Article

Acuracy and Concordance of Anthropometric Indicators and Body Composition in Heart Failure

Daniela de Oliveira Rocha et al. Raquel Costa Silva Dantas Fernanda Lambert de Andrade Regina Ranielly dos Santos Avelino … Clélia de Oliveira Lyra Rosiane Viana Zuza Diniz Niethia Regina Dantas de Lira Karine Cavalcanti Mauricio Sena-Evangelista

Abstract

Background:

Anabolic/catabolic disorder in heart failure (HF) favors cardiac cachexia, implying a reduction in HF survival.

Objectives:

To assess the accuracy and concordance of the diagnosis of protein malnutrition and excess fat among the anthropometric and body composition methods in individuals with HF.

Method:

A study of accuracy that included 60 individuals with HF. Body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TST), adductor pollicis muscle thickness (APMT), arm muscle circumference (AMC) and corrected arm muscle area (cAMA). Fat free mass index (FFMI) and body fat percentage (BF%), obtained by electrical bioimpedance (EBI), were used to compare the diagnosis of protein malnutrition and excess fat. Accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive value. The concordance of the EBI diagnosis and other methods was performed by the chi-square test and kappa (k) statistic, where p<0.05 was considered significant.

Results:

Higher frequencies of protein malnutrition were identified by cAMA and AMC, and excess fat by BF%. BMI presented low sensitivity (43%) and accuracy (38.5%), with moderate concordance (0.50). AMC sensitivity was 86%, accuracy 66.4%, and acceptable concordance (0.36) compared to FFMI. Similar percentages of moderate sensitivity and low accuracy were observed for TST and BMI.

Conclusion:

AMC may be useful to identify protein malnutrition and TST has not been adequate to diagnose adiposity. BMI was not sensitive to assess muscle and adipose reserve. EBI was more accurate.